The Clinician Strikes Again

Every week I receive at least one email from Donald’s clinician that pisses me off to the point of increased blood pressure and a serious amount of swearing. The emails usually come on Friday afternoons (although this one happened to come on Thursday).

He [Donald] did ask when he will be able to go on a home visit.  I tried to talk to him about his past behavior while at your home and how he may have scared you, but he shut down.  He stated he was here because of that, and he has been doing well with his anger.  I suggested he ask you about it, but I get the impression he won’t since he seems reluctant to discuss his role in why he is not in your home.

The big thing I got out of this meeting with Donald is that he has questions about his future and the not knowing is really stressing him out.  His mood throughout the meeting was all over the place, and that seems to be consistent across settings lately.  I know last night he required a Benadryl PRN due to escalation and not being able to control himself.  Today I assured him that the team is working on a plan, but I don’t think that will be enough.   I know we do not know what his future will be at the moment, but maybe Minnie and I could talk to him together about why he is not going on home visits that way he hears it from both of us?  Provided of course you are comfortable with this Minnie.  I just feel we need to give him something at this point.  He is starting the hard work about his past, but with nothing to work toward it can be difficult to maintain that motivation.

Honestly, where do I begin to address the many issues with this email? You told Donald that he “scared us”??? Are you kidding me?? I can’t begin to express why I am not okay with this. If, having known him for 3 months, you dont know about his need and enjoyment of controlling and instilling fear in others, you should probably head back to school or find another field to work in. Clearly, working with Reactive Attachment Disorder pre-teens in a residential setting is not for you.

Furthermore, are you sure scared is the right word? How about you try assaulted? Attacked? Kicked? Bit? Pinched? Scratched? Choked? Screamed at? Exposed yourself to? Terrified to the point of installing locks on all bedroom doors? Locking up all kitchen knives? How about digital RAPE and sodomization of the family dog? Does any of that come to mind?

Home visits? Really? We have taken him “off campus” only on 3 occasions in 3 months. Our weekly visits currently last 1 hour and sometimes he asks us to leave early. His mood is all over the place? He required a PRN due to escalation and not being able to control himself? But you think he is ready for home visits??? Really? You want me to drive him one hour each way to bring him back to the environment where he viciously attacked our family including choking his sister? No. Just no. And the fact you think this is even therapeutically warranted makes me question whether you should even be assigned to his case. You CLEARLY do not understand the risk he poses nor do you understand how this would be setting him up to fail. Again.

So you think you & I should sit down with Donald to discuss his future? Hmmm, let’s see… neither of us knows what his future holds. Neither of us single handedly make decisions about what his future holds either. The team has not made any decision beyond saying that the SOONEST he would come back would be April 2013. You dont want to tell him this yourself, so you have decided that WE should sit him down and tell him? Really? I remember you sitting across from me at the last team meeting. I know you heard me say that if I had to make a decision right now, we would not be taking him back. You also heard me say that his sisters therapist is going on record to recommend that these children should not be placed together. You heard the adoption specialist support this. You heard her recommend a consult to reinforce this. Yet, you maintain that you & I should “talk to him about his future”? Do you think he is ready to hear those things? Or are you suggesting that I lie to him and give him hope for a future that he would never be able to maintain? He has not received ANY real therapy since he left the psychiatric hospital in February, yet you believe you know what he is capable in the future? How things should go? Have you reviewed his records beyond the fluffed up adoption history that you were given? Have you seen the pattern of abuse he has subjected ALL former foster families to? Have you listened to his sister’s numerous requests for protection from him?

He has nothing to work towards without being led to believe he will return to us? I disagree. How about he needs to do this “hard work” so that he can survive in this world without ending up homeless, a high school drop out, jailed or worse. Or he should do this hard work so he has some hope of stable relationships in his lifetime? Do any of those things matter to you? Or is this just a race to the finish line so you can call yourself a success?

I am biting my tongue for now and letting the rest of the team deal with you. And I am very grateful that they have decided to transfer his TF-CBT to another agency to handle. Its his only hope because if his future lies in your hands, he is doomed.

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